Abstract

The subject of this paper is the distinction between (actively) bringing about and (passively) letting-happen, and the implications of the distinction in the ethics of decision-making, especially in cases of withdrawal of therapy in critical care. First, the no-difference arguments of Rachels and Tooley are outlined. Some counter-arguments to the no-difference thesis are brought forward, and it is concluded that all the no-difference arguments show is that in some cases the active-passive factor is relatively insignificant compared to other ethical factors. Yet the counterarguments make clear that in some cases, the active-passive factor is ethically critical. Therefore, as a general principle, the no-difference thesis must fail. Finally, it is argued that the no-difference thesis tends to misidentify action with bodily movement. Some discussion of how the active-passive distinction might be analysed is included.